Free birth control under health law starts today

Starting Wednesday, millions of American women will no longer pay for birth control pills, Pap smears or mammograms -- not even a co-pay. Women also have the right to free breast-feeding support, supplies for pregnancy-related diabetes, also known as gestational diabetes, and even screening for domestic violence.

It's not clear how many women will take advantage of the new policy, but the US Health and Human Services Department estimates that 47 million women, ages 15 to 64, have private health insurance plans that will be affected. The 2010 health reform law requires that policies provided by private health insurance companies pay for a list of women’s health preventive services, starting August 1.

However, there may be a delay in services for many women. The law applies to new policies -- women with existing coverage may have to wait for their policies to renew for the requirements to kick in, which could take months. Many health insurers already provide this coverage.

The new rules are based on guidelines from the independent, non-partisan Institute of Medicine, which said paying for these services will save money and lives down the road.

“We want healthy women to have healthy babies,” said Dr. Jennifer Howse, president of the March of Dimes Foundation, a charity that works to prevent birth defects. “Receiving regular medical care greatly increases the likelihood that important messages can be delivered to pregnant women around issues such as nutrition and tobacco cessation, and provides opportunities to detect potentially dangerous conditions like gestational diabetes or high blood pressure.”

There are a few exceptions. Purely religious employers don’t have to provide the services to employees if they object. Related groups, such as Catholic-affiliated universities, have objected so the Obama administration offered what it called an accommodation, forcing the insurance companies themselves to pay for the coverage. But the religious associations still object, as do Republicans in Congress. They have promised to repeal the whole law if they win enough seats in the November election.

On Friday, a federal judge in Colorado ruled that a Catholic-owned heating and air conditioning company in Denver did not have to provide contraception coverage for its workers.

Americans also get refunds starting today from health insurance companies that spent too much on administrative expenses. The law requires health insurance companies to spend at least 80 percent of premiums on actual medical care and not on salaries, office rental and other overheads.